Small Cell Lung Cancer

Features
usually central
arise from APUD* cells

Management

usually metastatic disease by time of diagnosis
patients with very early stage disease (T1-2a, N0, M0) may be suitable for surgery (NICE 2011)
however, most patients with limited disease receive a combination of chemotherapy and radiotherapy
patients with more extensive disease are offered palliative chemotherapy

Complications

SIADH
associated with ectopic ADH, ACTH secretion
ADH → hyponatraemia
ACTH → Cushing's syndrome
ACTH secretion can cause bilateral adrenal hyperplasia, the high levels of cortisol can lead to hypokalaemic alkalosis
Lambert-Eaton syndrome: antibodies to voltage gated calcium channels causing myasthenic like syndrome

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